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acute pancreatitis,mortality,sepsis

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https://www.readbyqxmd.com/read/29576768/effect-of-endotoxemia-in-suckling-rats-on-pancreatic-integrity-and-exocrine-function-in-adults-a-review-report
#1
REVIEW
Jolanta Jaworek, Barbara Tudek, Paweł Kowalczyk, Michalina Kot, Joanna Szklarczyk, Anna Leja-Szpak, Piotr Pierzchalski, Joanna Bonior, Artur Dembiński, Piotr Ceranowicz, Zygmunt Warzecha, Katarzyna Nawrot-Porąbka, Krzysztof Gil
Background . Endotoxin (LPS), the component of Gram-negative bacteria, is responsible for sepsis and neonatal mortality, but low concentrations of LPS produced tissue protection in experimental studies. The effects of LPS applied to the suckling rats on the pancreas of adult animals have not been previously explored. We present the impact of neonatal endotoxemia on the pancreatic exocrine function and on the acute pancreatitis which has been investigated in the adult animals. Endotoxemia was induced in suckling rats by intraperitoneal application of LPS from Escherichia coli or Salmonella typhi ...
2018: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29560667/epidural-analgesia-is-infrequently-used-in-patients-with-acute-pancreatitis-a-retrospective-cohort-study
#2
Y Sasabuchi, H Yasunaga, H Matsui, A K Lefor, K Fushimi, M Sanui
BACKGROUNDS AND AIMS: Epidural analgesia is an option for pain control in patients with acute pancreatitis. The aim of this study is to describe characteristics, morbidity and mortality of patients with acute pancreatitis treated with epidural analgesia. PATIENTS AND METHODS: Data was extracted from a national inpatient database in Japan on patients hospitalized with acute pancreatitis between July 2010 and March 2013. A total of 44,146 patients discharged from acute care hospitals were included in this retrospective cohort study...
July 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29513172/epidural-analgesia-is-infrequently-used-in-patients-with-acute-pancreatitis-a-retrospective-cohort-study
#3
Y Sasabuchi, H Yasunaga, H Matsui, A K Lefor, K Fushimi, M Sanui
BACKGROUNDS AND AIMS: Epidural analgesia is an option for pain control in patients with acute pancreatitis. The aim of this study is to describe characteristics, morbidity and mortality of patients with acute pancreatitis treated with epidural analgesia. PATIENTS AND METHODS: n on patients hospitalized with acute pancreatitis between July 2010 and March 2013. A total of 44,146 patients discharged from acute care hospitals were included in this retrospective cohort study...
July 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29401171/primary-and-secondary-organ-failures-cause-mortality-differentially-in-acute-pancreatitis-and-should-be-distinguished
#4
Rajesh Kumar Padhan, Saransh Jain, Samagra Agarwal, Suresh Harikrishnan, Padmaprakash Vadiraja, Sanatan Behera, Sushil Kumar Jain, Rajan Dhingra, Nihar Ranjan Dash, Peush Sahni, Pramod Kumar Garg
OBJECTIVE: The aim of this study was to study the development of early and late organ failure (OF) and their differential impact on mortality in patients with acute pancreatitis (AP). METHODS: Consecutive patients (N = 805) with acute pancreatitis were included in an observational study. Organ failure was categorized as primary if it occurred early due to pancreatitis per se and secondary if it occurred late due to infected pancreatic necrosis (IPN). Primary outcome was a relative contribution of primary OF, secondary OF, and IPN to mortality...
March 2018: Pancreas
https://www.readbyqxmd.com/read/29324628/ulinastatin-protects-against-lps-induced-acute-lung-injury-by-attenuating-tlr4-nf-%C3%AE%C2%BAb-pathway-activation-and-reducing-inflammatory-mediators
#5
Chao Cao, Chengfen Yin, Songtao Shou, Jun Wang, Lechang Yu, Xuening Li, Yanfen Chai
Acute lung injury (ALI) and its severe form, acute respiratory distress syndrome (ARDS), remain the leading causes of morbidity and mortality in intensive care units. Ulinastatin (UTI), a serine protease inhibitor, possesses anti-inflammatory properties and has been suggested to modulate lipopolysaccharide (LPS)-induced sepsis; thus, it is now widely used in the treatment of pancreatitis, sepsis, and septic shock. Toll-like receptor 4 (TLR4), an essential LPS signaling receptor, plays a critical role in the activation of innate immunity...
January 10, 2018: Shock
https://www.readbyqxmd.com/read/29222967/stimulation-of-the-endogenous-incretin-glucose-dependent-insulinotropic-peptide-by-enteral-dextrose-improves-glucose-homeostasis-and-inflammation-in-murine-endotoxemia
#6
Faraaz Ali Shah, Srikanth Singamsetty, Lanping Guo, Byron W Chuan, Sherie McDonald, Bryce A Cooper, Brett J O'Donnell, Darko Stefanovski, Burton Wice, Yingze Zhang, Christopher P O'Donnell, Bryan J McVerry
Loss of glucose homeostasis during sepsis is associated with increased organ dysfunction and higher mortality. Novel therapeutic strategies to promote euglycemia in sepsis are needed. We have previously shown that early low-level intravenous (IV) dextrose suppresses pancreatic insulin secretion and induces insulin resistance in septic mice, resulting in profound hyperglycemia and worsened systemic inflammation. In this study, we hypothesized that administration of low-level dextrose via the enteral route would stimulate intestinal incretin hormone production, potentiate insulin secretion in a glucose-dependent manner, and thereby improve glycemic control in the acute phase of sepsis...
March 2018: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/29209119/how-severe-is-moderately-severe-acute-pancreatitis-clinical-validation-of-revised-2012-atlanta-classification
#7
Povilas Ignatavicius, Aiste Gulla, Karolis Cernauskis, Giedrius Barauskas, Zilvinas Dambrauskas
AIM: To explore the outcomes and the appropriate treatment for patients with moderately severe acute pancreatitis (AP). METHODS: Statistical analysis was performed on data from the prospectively collected database of 103 AP patients admitted to the Department of Surgery, Hospital of Lithuanian University of Health Sciences in 2008-2013. All patients were confirmed to have the diagnosis of AP during the first 24 h following admission. The severity of pancreatitis was assessed by MODS and APACHE II scale...
November 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28870057/-clinical-analysis-of-34-cases-with-sepsis-and-systemic-capillary-leak-syndrome
#8
H X Ma, X J Shi, Y R Liang, H D Shi, H Wang, Y S Zhao
Objective: To study the clinical characteristics of sepsis with systemic capillary leak syndrome(SCLS) and to evaluate the therapeutic effect and clinical significance of fluid therapy adjusted timely in these patients. Methods: The clinical data of 34 patients with sepsis and SCLS in the Department of Hepatobiliary Surgery ICU of General Hospital of People's Liberation Army General Hospital from July 2014 to January 2016 were retrospectively analyzed.There were 21 males and 13 females, aged from 21 to 74 years, with an average age of 56...
September 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28487603/endoscopic-management-of-pancreatic-fluid-collections-revisited
#9
REVIEW
Zaheer Nabi, Jahangeer Basha, D Nageshwar Reddy
The development of pancreatic fluid collections (PFC) is one of the most common complications of acute severe pancreatitis. Most of the acute pancreatic fluid collections resolve and do not require endoscopic drainage. However, a substantial proportion of acute necrotic collections get walled off and may require drainage. Endoscopic drainage of PFC is now the preferred mode of drainage due to reduced morbidity and mortality as compared to surgical or percutaneous drainage. With the introduction of new metal stents, the efficiency of endoscopic drainage has improved and the task of direct endoscopic necrosectomy has become easier...
April 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28457384/liver-retransplantation-for-hepatic-abscess-due-to-hepatic-artery-thrombosis-a-case-report
#10
G Zanus, M Romano, M Finotti, E Dalla Bona, D Sgarabotto, D Bassi, C Mescoli, P Angeli, P Burra, E Gringeri, A Vitale, F D'Amico, P Feltracco, U Cillo
INTRODUCTION: Hepatic artery thrombosis (HAT) is a well-recognized complication of liver transplantation (LT). HAT is an important risk factor for infectious, in particular hepatic abscess, which can cause graft loss and increasing morbidity and mortality. CASE REPORT: We present a case report of complicated LT in a 52-year-old Caucasian man with primary sclerosing cholangitis. In 2007 the patient was included on the waiting list in Padua for LT. In 2012 the patient underwent percutaneous transhepatic biliary drainage for bile duct stricture, complicated with acute pancreatitis...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28436602/accuracy-of-circulating-histones-in-predicting-persistent-organ-failure-and-mortality-in-patients-with-acute-pancreatitis
#11
T Liu, W Huang, P Szatmary, S T Abrams, Y Alhamdi, Z Lin, W Greenhalf, G Wang, R Sutton, C H Toh
BACKGROUND: Early prediction of acute pancreatitis severity remains a challenge. Circulating levels of histones are raised early in mouse models and correlate with disease severity. It was hypothesized that circulating histones predict persistent organ failure in patients with acute pancreatitis. METHODS: Consecutive patients with acute pancreatitis fulfilling inclusion criteria admitted to Royal Liverpool University Hospital were enrolled prospectively between June 2010 and March 2014...
August 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28431202/pharmacological-interventions-for-acute-pancreatitis
#12
REVIEW
Elisabetta Moggia, Rahul Koti, Ajay P Belgaumkar, Federico Fazio, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: In people with acute pancreatitis, it is unclear what the role should be for medical treatment as an addition to supportive care such as fluid and electrolyte balance and organ support in people with organ failure. OBJECTIVES: To assess the effects of different pharmacological interventions in people with acute pancreatitis. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 9), MEDLINE, Embase, Science Citation Index Expanded, and trial registers to October 2016 to identify randomised controlled trials (RCTs)...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28411344/the-effect-of-a-novel-minimally-invasive-strategy-for-infected-necrotizing-pancreatitis
#13
Zhihui Tong, Xiao Shen, Lu Ke, Gang Li, Jing Zhou, Yiyuan Pan, Baiqiang Li, Dongliang Yang, Weiqin Li, Jieshou Li
BACKGROUND: Step-up approach consisting of multiple minimally invasive techniques has gradually become the mainstream for managing infected pancreatic necrosis (IPN). In the present study, we aimed to compare the safety and efficacy of a novel four-step approach and the conventional approach in managing IPN. METHODS: According to the treatment strategy, consecutive patients fulfilling the inclusion criteria were put into two time intervals to conduct a before-and-after comparison: the conventional group (2010-2011) and the novel four-step group (2012-2013)...
November 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28281124/major-pancreatic-duct-continuity-is-the-crucial-determinant-in-the-management-of-blunt-pancreatic-injury-a-pancreatographic-classification
#14
Being-Chuan Lin, Yon-Cheong Wong, Ray-Jade Chen, Nai-Jen Liu, Cheng-Hsien Wu, Tsann-Long Hwang, Yu-Pao Hsu
BACKGROUND: To evaluate the management and outcomes of blunt pancreatic injuries based on the integrity of the major pancreatic duct (MPD). METHODS: Between August 1996 and August 2015, 35 patients with blunt pancreatic injuries underwent endoscopic retrograde pancreatography (ERP). Medical charts were retrospectively reviewed for demography, ERP timing, imaging findings, management, and outcome. RESULTS: Of the 35 patients, 21 were men and 14 were women, with ages ranging from 11 to 70 years...
October 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28114931/procalcitonin-guided-diagnosis-and-antibiotic-stewardship-revisited
#15
REVIEW
Ramon Sager, Alexander Kutz, Beat Mueller, Philipp Schuetz
Several controlled clinical studies have evaluated the potential of the infection biomarker procalcitonin (PCT) to improve the diagnostic work-up of patients with bacterial infections and its influence on decisions regarding antibiotic therapy. Most research has focused on lower respiratory tract infections and critically ill sepsis patients. A clinical utility for PCT has also been found for patients with urinary tract infections, postoperative infections, meningitis, and patients with acute heart failure with possible superinfection (i...
January 24, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28017813/association-between-state-medical-malpractice-environment-and-postoperative-outcomes-in-the-united-states
#16
Christina A Minami, Catherine R Sheils, Emily Pavey, Jeanette W Chung, Jonah J Stulberg, David D Odell, Anthony D Yang, David J Bentrem, Karl Y Bilimoria
BACKGROUND: The US medical malpractice system assumes that the threat of liability should deter negligence, but it is unclear whether malpractice environment affects health care quality. We sought to explore the association between state malpractice environment and postoperative complication rates. STUDY DESIGN: This observational study included Medicare fee-for-service beneficiaries undergoing one of the following operations in 2010: colorectal, lung, esophageal, or pancreatic resection, total knee arthroplasty, craniotomy, gastric bypass, abdominal aortic aneurysm repair, coronary artery bypass grafting, or cystectomy...
March 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27917667/prophylactic-antibiotics-in-acute-pancreatitis-endless-debate
#17
M M Mourad, Rpt Evans, V Kalidindi, R Navaratnam, L Dvorkin, S R Bramhall
INTRODUCTION The development of pancreatic infection is associated with the development of a deteriorating disease with subsequent high morbidity and mortality. There is agreement that in mild pancreatitis there is no need to use antibiotics; in severe pancreatitis it would appear to be a logical choice to use antibiotics to prevent secondary pancreatic infection and decrease associated mortality. MATERIALS AND METHODS A non-systematic review of current evidence, meta-analyses and randomized controlled trials was conducted to assess the role of prophylactic antibiotics in acute pancreatitis and whether it might improve morbidity and mortality in pancreatitis...
February 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27668746/open-surgical-versus-minimal-invasive-necrosectomy-of-the-pancreas-a-retrospective-multicenter-analysis-of-the-german-pancreatitis-study-group
#18
Sebastian Rasch, Veit Phillip, Stephanie Reichel, Bettina Rau, Christian Zapf, Jonas Rosendahl, Ulrich Halm, Markus Zachäus, Martin Müller, Alexander Kleger, Albrecht Neesse, Jochen Hampe, Mark Ellrichmann, Felix Rückert, Peter Strauß, Alexander Arlt, Volker Ellenrieder, Thomas M Gress, Werner Hartwig, Ernst Klar, Joachim Mössner, Stefan Post, Roland M Schmid, Thomas Seufferlein, Marco Siech, Jens Werner, Uwe Will, Hana Algül
BACKGROUND: Necrotising pancreatitis, and particularly infected necrosis, are still associated with high morbidity and mortality. Since 2011, a step-up approach with lower morbidity rates compared to initial open necrosectomy has been established. However, mortality and complication rates of this complex treatment are hardly studied thereafter. METHODS: The German Pancreatitis Study Group performed a multicenter, retrospective study including 220 patients with necrotising pancreatitis requiring intervention, treated at 10 hospitals in Germany between January 2008 and June 2014...
2016: PloS One
https://www.readbyqxmd.com/read/27663180/clinical-predictors-of-hospital-mortality-differ-between-direct-and-indirect-ards
#19
Liang Luo, Ciara M Shaver, Zhiguo Zhao, Tatsuki Koyama, Carolyn S Calfee, Julie A Bastarache, Lorraine B Ware
BACKGROUND: Direct (pulmonary) and indirect (extrapulmonary) ARDS are distinct syndromes with important pathophysiologic differences. The goal of this study was to determine whether clinical characteristics and predictors of mortality differ between direct or indirect ARDS. METHODS: This retrospective observational cohort study included 417 patients with ARDS. Each patient was classified as having direct (pneumonia or aspiration, n = 250) or indirect (nonpulmonary sepsis or pancreatitis, n = 167) ARDS...
April 2017: Chest
https://www.readbyqxmd.com/read/27628232/-role-of-correction-of-the-syndrome-of-intestinal-failure-and-abdominal-hypertension-in-the-prevention-of-infection-of-pancreatic-necrosis
#20
M D Dibirov, A I Isaev, A B Jadjiev, A I Ashimova, T Ataev
UNLABELLED: The number of patients with acute pancreatitis and pancreatic necrosis has been steadily increasing. Mortality in infected pancreatic necrosis remains high. AIM: To develop measures to prevent infection of pancreatic necrosis by timely correction of intra-abdominal hypertension and the syndrome of intestinal failure. MATERIAL AND METHODS: Developed a package of measures, consisting of early intestinal lavage and enterosorption, intravenous highdoses of octreotide, epidural blockade, adequate detox and the start of effective antimicrobial therapy...
2016: Khirurgiia
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